For the past two years I have been working with a team of seven colleagues writing and developing the new “Standards of Practice and Standards of Professional Performance for Registered Dietitians in Disordered Eating and Eating Disorders.” The article was published in the August 2011 issue of the Journal of the American Dietetic Association (pp. 1242-9, volume 111, number 8). You can preview the article here, though you will need to register to read the full text of the article.
Each of us is touched by at least one person who has mentored or inspired us to follow our passion. If it were not for that person’s influence, life as we experience it, might have been altogether different. Sometimes that influence comes at a time when we are vulnerable, perhaps after an especially challenging time. At other times we learn most when our life seems invincible and creativity flows almost effortlessly. Either way, learning and awakening of the spirit occurs when we open to the influence of mentors who can act as catalysts for change.
Since behavior change is what so many people are after when it comes to eating, why not take a look at how we learned best from those who have inspired us along the way? Did you try becoming a vegetarian because of a family member or friend who inspired you to shift to plant-based food for health or sustainability reasons? Or did you experience fresh, wholesome food when on a retreat and that experience motivated you to try growing vegetables and herbs to spark up your meals?
In my case, my mother inspired me with her compassion for humanity, her sense of wonder, and her positive nature; I learned to appreciate examples of beauty and joy in real time. Somehow I learned to open to the potential for growth through her brand of curiosity for people and what they could achieve, whether it was artistic expression or just getting beyond a rocky time.
I am grateful to her for inspiring me to learn, grow and smile on life.
Read the full interview here. David Kessler, MD, former head of the FDA has come up with a compelling argument that lays much of the cultural problem of overeating at the feet of the food industry. Here is an excerpt from the interview:
WSJ: Are we then all victims of subtle cravings whose genesis we’re doomed never to understand?
Dr. Kessler: This syndrome of conditioned hyper-eating, which is what this is — the loss of control in the face of highly palatable foods, lack of feeling full — is reward-based eating. Not all are equally susceptible. Those obese and overweight have a greater incidence. But even 20% of the healthy report occasional loss of control. You will find people for whom food doesn’t capture their interest, but it’s probably a small percentage of the population. For the rest of us, it’s a continuum. It’s not only conditioned behavior. It’s the learning and motivational circuits of the brain being captured. Is it nurture or nature? You expose children who are eating fat, sugar and salt all day. They’ve never been hungry a day in their lives. Once you lay down that neuro-circuitry, it’s there for life. The actual act of consumption isn’t as strong as anticipation. It’s the conditioning associated with a cue. Once you are cued and you’re activated, it amplifies the reward value. It torments you. You want it more.
Scary stuff, but I am convinced that the practice of mindfulness can be applied to overcoming the conditioning of our minds to hyper-eating. Skill development and practice may not fully quiet our minds, but we can be taught to feed ourselves as we were designed to be fed, one bite at a time.
His Holiness the 14th Dalai Lama, Tenzin Gyatso, participated in a conference organized by the Harvard Medical School and Cambridge Health Alliance this weekend in Boston. The hundreds of us who attended experienced his humor, insight and wisdom as he answered questions from some of the world’s most experienced psychotherapists, physicians, deans, scholars and healers about the many ways that meditation and the cultivation of compassion can influence mental health. His Holiness engaged in discussions of how Buddhist teachings and practice can be useful in treating human suffering including trauma, illness and anxiety. He shared a personal story of surprise and disappointment when he, as a boy, tried to propagate a favorite flower by placing a cutting in soil. After only a few days he examined the cutting, hoping to find a root system that had not yet emerged. He had not developed the wisdom to give the time and nutrition required to grow a healthy new flower.
And yet just the day before addressing those of us at the conference, he demonstrated his mastery of the skill that had eluded him in his youth when he planted a tree with great gusto in Harvard Yard. The unique hybrid birch, bred by Harvard arborists from a blend of Asian and North American birches, meant to honor His Holiness and the role he has played as a thought leader across continents, was ceremoniously planted by Dalai Lama, Harvard’s president, Drew Gilpin Faust and the deans of the divinity and education schools. The Dalai Lama offered thanks and stated that the tree would likely outlast both them all, but would remind future generations of his visit. He went on to encourage more than the symbolic turning over of a few light shovelfuls of dirt, but instead mindfully engaged in the work of planting and watering the tree with the wisdom he had cultivated over time.
As I took in the often surprising tales of risks and creative thinking that the thought leaders had utilized to incorporate aspects of Buddhist practice into their life’s work, I was encouraged and relieved. Not only for my clients, who are continually weighing hope against self-doubt as they struggle to overcome medical problems often complicated by emotional challenges. But the message of the our ability to change over time, on a cellular, biochemical and emotional level, gave me hope that each of us has the ability to self-nurture and grow new and stronger roots that may in turn bring the wisdom and compassion that have the potential to benefit others and possibly ourselves.
My children had a favorite bedtime story about a certain frustrated pastry chef named Marcel, who awaked every night to creep down to the palace kitchen where he baked and presumably ate sweet confections. The king attributed the delectable desserts to the palace baker until one night, when the smells of the pastries drew the king to the kitchen, he discovered Marcel tasting his way through his very own cream puff confections. Once Marcel was outed as the creator, he was handsomely rewarded and promoted to the royal pastry chef.
For those who struggle with night eating patterns, there is no positive reinforcement of their nocturnal behavior. In fact for these individuals, night eating represents a loss of control and a behavior which they strive to overcome. Recognized as early as 1955 by Dr. Albert Stunkard, Night Eating Syndrome (NES) has received increased attention by clinicians who treat eating disorders, yet many who suffer from NES are unaware of the syndrome or its treatments.
Night eating is often associated with mood disorders; those with night eating patterns scored higher for depression and had lower self esteem than controls. They often report that they experience a worsening mood as the day wears on and that they turn to food for comfort or to help them sleep.
NES is characterized by eating the majority of one’s calories after dinner, but not all night eaters eat in the middle of the night. Night eaters typically skip breakfast and don’t have an appetite until several hours into their day. Their evening meals or the snacks after dinner tend towards high carbohydrate foods such as crackers, bread or sweets. The night eating patterns persists several times per week and last for months, if not years and can lead to obesity, though this is not always the case.
Until recently researchers wondered about the biology of night eating patterns and they are beginning to get some answers. One of the keys may lie in the neurotransmitter profiles of individuals with night eating patterns. They don’t seem to derive the same pleasure from eating that others do, indicating that they may be suffering from more than guilt. In fact, their brains may have a hard time getting an amino acid called tryptophan, which converts to seratonin, the so-called ‘feel good’ neurotransmitter. These individuals may also have trouble making enough melatonin, another neurotransimtter that regulates sleep.
Nutritional management of night eating involves more than adding foods into the daylight hours, though that is often a first step. Careful analysis of the eating and activity patterns, along with a thorough medical and psychosocial assessment can begin to unravel the clues to the fundamentals of the individual’s night eating patterns. Not unlike other eating disorders, treatment may involve a team that includes physicians, therapists and nutritionists working side by side with an observant, if not always alert, night eater.
Can you imagine ever considering any possible nutritional merits of lard? Maybe not, but the Wall Street Journal reported that a new generation of “foodies” who strive to create the most delectable dishes have begun throwing decades old dietary recommendations aside to the dismay and disgust of unsuspecting diners. Grandmothers who bake memorable pies and famous international chefs have long realized that using lard or even vegetable shortening such as Crisco can help to create taste sensations. But the health recommendations of the past half-century have trained us to react with horror at the mere thought of eating saturated fat which seems to conjure up images of arteries clogging before we get to the third bite of pecan pie with a lard-based crust.
Before the advent of vegetable oils swept our television screens with Mazola and sunflowers, people in many agriculturally-based societies spread butter or lard on bread with gusto. The bias against lard that has kept it away from our palates for decades apparently coincided with the introduction of Crisco a plant-based shortening in 1911. Back in 1940 American consumed a record 14.4 pounds of lard per capita; but by 1997, American consumption of lard reached its lowest point, 2.9 pounds per capita.
Nutritionists warned against eating lard due to its saturated fat content, which turns out to be less than butter’s. The big surprise is that lard provides more monounsaturated fats (the most favored fats of late) and a lot less polyunsaturated fats than vegetable oils, which are now linked to increased cancer risk.
I am not saying that I recommend lard with your morning oatmeal and raisins, but perhaps we could try to recognize at least a portion of the bias and cognitive distortions we bring to our everyday eating. How much damage could one slice of sweet potato pie truly do if we applied the skills of cognitive behavioral therapy (CBT), the psychotherapeutic approach that aims to modify our dysfunctional thoughts and emotions and behaviors through challenging our distorted beliefs? Is it possible that the introduction of the ultimate challenge food might turn out to be healthy after all?
For National Eating Disorders awareness week, I was interviewed on Fox News about America’s most common eating disorder—Binge Eating Disorder (BED). I explain some of the challenges that binge eaters face and outline the basics of treatment.
So it turns out that loneliness contributes to overeating. We knew that already, but John Cacioppo of the University of Chicago, recently outlined his findings at the American Association for the Advancement of Science annual conference. His work shows that social isolation contributes to decreased blood flow throughout the cardiovascular system and higher levels of the stress hormone cortisol, which affects the immune system and may influence appetite and metabolism and yes, even depressed mood.
Lonely people are more apt to quit an exercise program and they are more likely to eat high calorie foods in large portions to self-soothe. Food can become the best companion and the preferred entertainment on another lonely Saturday night. It comes as no surprise that an extra serving ot two of lasagna followed by enough cannoli to leave a diner in physical distress may seem like the perfect sedative when sleepless nights have become routine. But the short-lived comfort leaves a wake of restless tossing and turning, stomach aches and demoralizing self-talk that can be more stressful than the pre-binge anxiety.
If we can retrain our habits so that we learn to recognize the triggers (the creepy boss or the incredibly annoying date) that got us even thinking about self-soothing with cannoli, we can get a handle on slowing down the process and eventually allow ourselves to gently intervene in the lonely food-is-love practice. By mastering a set of skills aimed at praticing new ways of finding the support and comfort we crave more than Mom’s lasagna, we can groove new tunes to repair our lonely hearts.
People are becoming increasingly aware of the way we humans have been wired to eat foods which distract us from what we thought we had planned to eat only a few hours earlier. Imagine the irresistible smell of walking by your favorite restaurant just after you’ve gotten out of a long meeting and missed your regular meal time. Your brain experiences the enticing visual and olfactory sensations which drive your behavior in a new direction. In this case you might stop in for at least a sample of the best blackberry cobbler in town, say, even if it means that you will be late for your next meeting. This culinary diversion sends powerful signals to the brain’s reward center even when you only get a few bites into the thrill.
But just as you bite into the warm and gooey sensation, you get a call from your kid’s babysitter, who tells you that you need to get home in time to take your darling to dance class. You decide to rush through the rest of the cobbler, but by now your mind has shifted to the next task, and you are barely even present, when you down what started out as a self-care opportunity.
Distraction from eating is what generated the entire mindful eating craze. Now nutritionists write books, develop programs and coach willing participants into slowing down, literally smelling the cobbler, and allowing themselves to more fully experience eating, in the hope that the focus will enable them to learn to balance fueling their spirits with the kind of nourishment that fuels their bodies.
Enter the BlackBerry to make the learning curve even steeper. Now we all have to learn to experience life in twits and chirps. Bringing the BlackBerry to the table can seriously put a dent in the mindful eating experience, leaving a motivated dieter to be confused beyond belief. If neuroscientists are correct that we can only multitask so much at one time, then doesn’t it stand to reason that the out-of-control eating that seems to be driving the obesity epidemic, will be made even worse by our increasing reliance on tools like the BlackBerry that remove us from the experience of everything we do, from cooking, to eating, to conversing over a meal?
I once had the pleasure of hearing Julia Child herself as a keynote speaker at an American Dietetic Association conference. She managed to both charm and alienate some in the audience by pooh-poohing the association’s focus on nutritional value of foods, but she emphasized the loss of the family table as the main culprit to the health woes of Americans. Might she have checked her messages on a BlackBerry as she sipped wine and turned out culinary delights? I doubt it.